Roux-en-y gastric bypass surgery is a type of weight-loss surgery that reduces your stomach size and re-routes part of the small intestine. The reduction in stomach size allows you to eat smaller food portions, while the re-routing of the small intestine helps you absorb fewer calories from the foods you eat. Gastric bypass surgery can help you lose excess weight and reduce your risk for obesity-related medical conditions as a result.

How can gastric bypass surgery help me lose weight?

Having a smaller stomach allows you to eat smaller food portions, feel full sooner, and avoid overeating. With gastric bypass, a portion of the small intestine is re-routed and formed into a “Y” shape that allows food to bypass most of the section that absorbs calories — including calories from fatty foods. This re-routing of the intestine produces a narrower tunnel between the stomach and intestine that helps you stay full for longer periods of time so you end up eating less.

Following gastric bypass surgery, your stomach volume will be roughly one ounce, and your food intake will be limited to about ½ cup at each meal. As time goes by, the changes made to your stomach and intestine will help you gradually lose weight as you consistently eat smaller food portions and absorb fewer calories.

Roux-en-y gastric bypass surgery can be performed as a minimally invasive laparoscopic procedure so you can benefit from a faster recovery, shorter hospital stay, less scarring, and a reduced risk for complications. With laparoscopic gastric bypass, your surgeon makes a few tiny incisions on your abdomen and inserts tiny surgical tools into these incisions to perform the surgery. Laparoscopic surgery is often far safer than open surgery and reduces the level of trauma on your body.

What happens during gastric bypass surgery?

gastric bypass surgeryRoux-en-y gastric bypass is performed under general anesthesia so you can sleep comfortably for the duration of the procedure. This weight-loss surgery usually takes between two and four hours to complete, after which you’ll be closely monitored by medical staff to ensure there are no complications.

First, your surgeon makes four to six incisions in your abdominal region. These incisions are made in spots that allow your doctor to re-route the small intestine and staple part of your stomach to create a smaller stomach pouch. Next, your doctor inserts a tiny camera called a laparoscope into your stomach, along with small surgical tools to perform the gastric bypass.

What are the advantages of Roux-en-Y gastric bypass?

Gastric bypass surgery comes with many pros for those who are obese and have had difficulty losing weight using conventional methods like diet and exercise. Obesity increases your risk for serious health problems including hypertension, type 2 diabetes, heart disease, and many more. The amount of excess weight you can lose after having roux-en-y gastric bypass surgery can help reduce your risk for obesity-related medical conditions.

Here’s a closer look at the pros of gastric bypass surgery.

Improved happiness and well-being

Gastric bypass can help you experience a higher level of happiness and mental well-being both directly and indirectly. Losing excess weight can make you feel more confident about your appearance and more accomplished when you’re finally able to reach long-held weight-loss goals and milestones. Weight loss also helps rebalance brain chemicals like serotonin and dopamine to ward off depression and anxiety.

Excess weight loss

Most gastric bypass patients lose between 60 and 80% of their excess weight after having this procedure and keep off 50% of their excess weight long-term. Those who have tried losing excess weight in the past by going on different diets, improving their nutrition, and exercising regularly can successfully lose excess weight after having gastric bypass surgery.

Reversal of type 2 diabetes

Gastric bypass surgery can help people lose enough excess weight to reverse or improve type 2 diabetes. A study involving morbidly obese individuals who suffered from type 2 diabetes found that diabetes-related mortality after gastric bypass surgery decreased by 92%. Excess weight loss can help normalize blood sugar and other hormones in ways that greatly improve type 2 diabetes.

Faster recovery

Laparoscopic roux-en-y gastric bypass is a minimally invasive procedure that offers far less downtime and faster recovery than traditional open surgery. Hospital stays for those who have laparoscopic gastric bypass is usually only two to four days, while open surgery often results in hospital stays of seven days or longer. Plus, the incisions made during laparoscopic gastric bypass are tiny and heal faster, while the incisions from open surgery are larger and may take days or weeks longer to heal. Any pain you experience following laparoscopic gastric bypass is usually minimal and can be treated using over-the-counter pain medicines like ibuprofen or acetaminophen.

What are the risks associated with roux-en-y gastric bypass?

Any type of surgery comes with its own risks — including minimally invasive gastric bypass surgery. Weight regain is one of the largest risks associated with gastric bypass, and can happen when patients gradually increase their food portions or stop exercising. Many gastric bypass patients end up gaining back up to 25% of the excess weight they initially lost by the 10-year mark after having their procedures. Fortunately, weight regain can be prevented by following your doctor’s post-op instructions and adhering to healthy meal and exercise plans.

Here are other risks associated with gastric bypass surgery.

Malnutrition

Decreased calorie absorption is one of the biggest advantages to having roux-en-y gastric bypass because it helps you lose excess weight. However, this advantage can quickly turn into a risk if you’re not eating healthy, nutrient-dense foods. The re-routing of the small intestine can often prevent your body from absorbing vitamins, minerals, and other important nutrients from foods like fruits, vegetables, nuts, and high-quality proteins. This can lead to malnutrition and nutritional deficiency if you’re not taking nutritional supplements. To avoid malnutrition following gastric bypass surgery, ask your doctor for guidance with nutrient intake in the form of supplementation.

Dumping syndrome

Gastric bypass patients are more prone to suffering dumping syndrome than other weight-loss surgery patients. Dumping syndrome is a set of symptoms that occur when food moves from the stomach pouch to the intestine too quickly before it has a chance to be completely digested. Dumping syndrome produces symptoms including sweating, nausea, vomiting, diarrhea, and extreme bloating.

To avoid dumping syndrome, eat foods high in protein and fiber that slow digestion like fruits, vegetables, fish, and poultry. Stay away from sugary, highly processed foods like candy, soda, cookies, cakes, and sweet breads, since these foods can quickly trigger dumping syndrome.

Potential complications

Dumping syndrome is one of the most common complications of gastric bypass surgery. Other complications associated with this weight-loss procedure include leaking at surgical sites such as the stomach pouch and intestine, gastrointestinal hemorrhage, gallstones, and bowel obstruction. Consult with your doctor immediately if you suspect you may be suffering complications from gastric bypass surgery so you can undergo revision surgery if necessary.

How do I prepare for roux-en-y gastric bypass?

Gastric bypass surgery is a procedure that will permanently change your stomach size and intestine function. This surgery requires you to make positive lifestyle changes that can help you lose excess weight and stay healthy for the rest of your life. Before gastric bypass, your doctor may require you to join a weight-loss education program, receive nutrition counseling, begin a fitness routine, and receive a mental health evaluation to ensure you’re truly ready to undergo this important life-changing surgery.

Stop smoking as far ahead of gastric bypass as possible to reduce the risk for complications and to avoid a slow recovery. Also, try losing as much excess weight as possible before your procedure to reduce your liver size and improve your chances of experiencing a safe, successful surgery. Your doctor may advise you to stop taking medications such as aspirin and ibuprofen that increase the risk for complications like blood clots.

During the week before your roux-en-y gastric bypass, make pet and childcare arrangements as necessary for the day of your procedure, and stock up on plenty of post-op liquids and foods as recommended by your doctor. Clean your home and set up a cozy spot in your living room or bedroom where you can relax and comfortably recover from your weight-loss surgery.

Gastric bypass pre-op video

Gastric Bypass Laparoscopic Surgery PreOp® Patient Education

Video Transcription

Video Description and Transcription

Description:
Gastric Bypass Laparoscopic Surgery PreOp® Patient Education

Transcription:

Your doctor has recommended that you undergo laparoscopic gastric bypass surgery. But what does that actually mean? Gastric bypass is a surgical procedure used to help a patient lose weight. It is usually recommended to help those who are morbidly obese, meaning that their weight problem has become a serious health risk.

Most severely overweight patients overeat. Food enters the body though the mouth, travels down the esophagus, where it collects in the stomach. From there, digested food passes into the small intestine. Nutrients taken from the food pass from the small intestine into the bloodstream. Waste travels to the colon and leaves the body through the anus.

The amount of food that a person eats is partly controlled by appetite. The stomach plays an important role in controlling appetite. When the stomach is empty, a person feels the urge to eat. When the stomach is full, that urge goes away.

Gastric bypass dramatically reduces the size of the stomach. With a smaller stomach, the patient is physically unable to eat large amounts of food.

Gastric bypass also shortens the small intestine, so that the body absorbs less of the food eaten. With less food entering the body, fat stores begin to be used. The patient loses weight.

Surgical procedures performed by making an incision large enough to expose the entire operative area are called open procedures. Your doctor believes that your medical condition and overall state of health make you a good candidate for a less intrusive laparoscopic surgery.

A laparoscope is a narrow tube that contains a light source and a small video camera. Using a laparoscope, the surgeon is able to operate by making one or more very small incisions, through which the sterile laparoscope, and possibly other instruments, are inserted into the body.

Using the laparoscope’s video camera, the surgeon is able to explore and inspect the interior of the abdomen, often allowing the surgeon to see with greater detail and with more clarity than with the human eye alone. However, it is important to understand that during the procedure, your surgical team is always prepared to convert a laparoscopic procedure to an open procedure should they feel that your condition requires a more direct approach.

If the surgical team makes this decision, you will find upon waking up that your doctor has made a larger incision and that healing may proceed more slowly.

Converting to an open procedure will affect the length of your recovery and will probably require hospitalization. Of course, no surgery is completely risk free, but your physician believes that if you decide not to undergo the recommended procedure, you may be putting your health at risk.

What happens after gastric bypass surgery?

Before you leave the hospital to go home, your doctor will give you a detailed list of post-op instructions for wound care and nutrition. For the first few weeks following gastric bypass, you’ll be restricted to liquids only so your stomach can properly heal and adjust to its smaller size. After the liquids-only phase, you can transition to soft, pureed foods before moving on to solid foods upon your doctor’s approval.

After your body has fully healed from surgery, you must resume your fitness routine so you can continue losing excess weight and maintain good overall health. You must also omit unhealthy foods from your diet and stick to eating nutritious, whole foods that deliver an adequate amount of vitamins and minerals. Exercising regularly and practicing good nutrition can help you lose excess weight and reduce the risk for complications from gastric bypass such as weight regain and dumping syndrome.

Who are ideal candidates for gastric bypass surgery?

People who have a body mass index of 40 or higher are ideal candidates for gastric bypass surgery. Gastric bypass is also ideal for those with a BMI between 35 and 40 who suffer comorbidities such as type 2 diabetes, hypertension, and heart disease.

Is gastric bypass surgery ideal for me?

Gastric bypass surgery may be ideal for you if you have a BMI of 40 or higher, or a BMI of 35 or higher and one or more obesity-related health conditions or comorbidities. You may also qualify for gastric bypass if you have a high BMI and have tried other weight-loss methods without experiencing long-term success.

Use our bariatric surgery directory to locate doctors in your area who specialize in weight-loss surgery and who are ready to help you meet your weight-loss goals. Bariatric procedures like gastric bypass can help you lose and keep off excess weight and help you achieve a healthier lifestyle.

Most people who need to lose 65 or more pounds have tried multiple times to lose the weight on their own. While they may have some success at first, less than five percent of people keep the weight off for five years or more. 

– Philip Schauer, MD, bariatric surgeon and Director of Cleveland Clinic’s Bariatric and Metabolic Institute

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